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The Effectiveness of Outpatient Appointment Reminder Systems in Reducing No-Show Rates

Outpatient automated reminder systems are less effective in reducing no-show rates compared to receiving a reminder from live, clinic staff. Type of reminder, age, visit type, wait time, division specialty, and insurance type are significant predictors of no-shows to appointments.


Patients who do not keep physician appointments (no-shows) represent a significant loss to healthcare providers. For patients, the cost includes their dissatisfaction and reduced quality of care. An automated telephone appointment reminder system may decrease the no-show rate. Understanding characteristics of patients who miss their appointments will aid in the formulation of interventions to reduce no-show rates.


In an academic outpatient practice, we studied patient acceptance and no-show rates among patients receiving a clinic staff reminder (STAFF), an automated appointment reminder (AUTO), and no reminder (NONE). Patients scheduled for appointments in the spring of 2007 were assigned randomly to 1 of 3 groups: STAFF (n=3266), AUTO (n=3219), or NONE (n=3350). Patients in the STAFF group were called 3 days in advance by front desk personnel. Patients in the AUTO group were reminded of their appointments 3 days in advance by an automated, standardized message. To evaluate patient satisfaction with the STAFF and AUTO, we surveyed patients who arrived at the clinic (n=10,546).


The no-show rates for patients in the STAFF, AUTO, and NONE groups were 13.6%, 17.3%, and 23.1%, respectively.

A clinic staff reminder was significantly more effective in lowering the no-show rate compared with an automated appointment reminder system.

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— Amay Parikh, MD, MBA, MS, Kunal Gupta, MD, MBA, Alan C. Wilson, PhD, Karrie Fields, CPC, Nora M. Cosgrove, RN, John B. Kostis, MD

This article originally appeared in the June 2010 issue of The American Journal of Medicine.

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